Liaqat Ali, Afrose Liaqat.
Effect of single evening dose of 1 mg dexamethasone in patients with late onset congenital adrenal hyperplasia due to 21 hydroxylase deficiency.
Isra Med J Jan ;5(1):35-40.

OBJECTIVE: To evaluate the phenotypic response of non classical or late onset congenital adrenal hyperplasia (CAH) to 1 mg overnight dexamethasone taken orally STUDY DESIGN: Observational study PLACE AND DURATION: Military Hospital Rawalpindi, from 1998 to 2001 METHODOLOGY: A total of 20 cases diagnosed in this period were followed every three months for one year to evaluate the phenotypic response in these patients. Patients were included on the basis of raised basal or post ACTH stimulated serum 17 hydroxyprogesterone on a sample of fasting blood. Patients not completing four three monthly follow up visits and/or irregular intake of 1 mg dexamethasone tablets were excluded from the study. RESULTS: Out of 20 cases, 15% (n=3) patients could not complete follow up visits. Of remaining 85% (n=17) patients, 59% (n=10) patients having hirsutism showed marked improvement and were left with very fine thin hairs only over chin. There was little or no response in 29 %( n=5) cases presenting with advanced bone age and large phallus. 6 %( n=1) patient primarily presenting with primary infertility and another with hirsutism and amenorrhea became pregnant during the treatment. CONCLUSION: 1 mg dexamethasone taken orally at night in patients with late onset CAH is effective because of its low cost, easy availability, good compliance and no side effects.

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